Dr. Stephanie

Newsletter Articles
June 2020

  • Resolution of Breech Presentation Confirmed by Ultrasound Following Chiropractic
  • Chronic Opioid Use for Back Pain by US Veteran Helped by Chiropractic
Resolution of Breech Presentation Confirmed by Ultrasound Following Chiropractic

Resolution of Breech Presentation Confirmed by Ultrasound Following Chiropractic

The Journal of Pediatric, Maternal & Family Health published the results of a case study on May 14, 2020, documenting the resolution of a breech presentation pregnancy following chiropractic care utilizing the Webster technique. The normal position for a fetus prior to birth is with the head downward, known as the "vertex position." When the fetus has the head upward, it is known as breech.

According to the study "The most common fetal malposition is breech. About 30% of all fetuses will present as breech before 28 weeks of gestation, but by the 34th week a majority will flip to vertex presentation, the ideal position for delivery." When discovered, most breech presentations result in a cesarean birth instead of the vaginal one.

The medical approach to turning a fetus when the mother is close to birth is a procedure known as external cephalic version (ECV). This is when the physician physically pushes the baby inside the mother in an attempt to return the baby to a normal position. This procedure is not without a high risk of complications and, according to the study, has a fairly low success rate.

In this case, a 28-year-old woman in the 33rd week of her pregnancy went to the chiropractor to see if she could get some help with her breech pregnancy. The woman had been seeing a midwife who was present when the woman came to the chiropractor. This was the woman’s first pregnancy, and she had never experienced chiropractic care before. The woman was also suffering from hip pain on both sides.

A chiropractic examination was performed which included a visual postural inspection, range of motion examinations, spinal palpation, a temperature thermal scan, and a surface EMG scan of the woman’s spine. The woman was also analyzed using the Webster Technique analysis.

With the determination of the presence of subluxations, specific adjustments utilizing the Webster technique were performed on the woman on a series of visits. After eight visits, the woman reported that the fetus had turned head down into the normal vertex position. The woman continued her chiropractic care through her pregnancy and was able to deliver her baby vaginally.

In the discussion section of the study, the authors explain chiropractic care for pregnancy by saying, "Chiropractic has a history of benefit to the pregnant woman. Chiropractic adjustments are intended to remove or reduce vertebral subluxations from the spine." They continue the explanation, "Chiropractors determine the subluxations through appropriate instrumentation, objective and subjective analysis. Chiropractic subluxations can have health alterations present with and without symptoms."

In their conclusion the authors wrote, "Over a one-month period the fetus turned from breech presentation to vertex presentation with the only change in care being the addition of chiropractic adjustments. After 7 chiropractic adjustments it was confirmed by ultrasound the fetus had moved to a vertex position. Continuing under chiropractic care the mother went on to have a normal vaginal birth without complications."

Chronic Opioid Use for Back Pain by US Veteran Helped by Chiropractic

Chronic Opioid Use for Back Pain by US Veteran Helped by Chiropractic

The Journal of Contemporary Chiropractic published the results of a case study on May 18, 2020, documenting the improvement under chiropractic care of a U.S. veteran with lower back pain who had previously been using opioids for ten years to manage his pain.

In the opening of the study, the authors clearly state their objective. "To demonstrate the ability for a patient with chronic mid and low back pain to make significant improvements, both in pain score and quality of life, under chiropractic care, even after a decade of management using daily opioids."

It is obvious to everyone that there is an opioid problem in the United States and around the world. This awareness has caused a shift in the thought of how to best address back issues. Because of this, the American College of Physicians (ACP) updated their Clinical Practice Guideline for the Treatment of Chronic Low Back Pain in 2017 to state that their first recommendation for chronic lower back pain (LBP) was to use spinal manipulation, exercise, and multidisciplinary rehabilitation prior to pharmaceutical intervention as a first line of defense. Only after several trials of unsuccessful conservative management for LBP was medical treatment with opioids to be considered.

In this case, a 50-year-old male veteran went to the chiropractor, seeking help for chronic mid and low back pain that radiates into his legs. He had been seeing medical physicians through the Veterans Affairs, who had been treating him with opioids in the form of hydrocodone and morphine for the past 10 years. He was forced to discontinue activities such as biking and weightlifting due to his pain. During flair-ups, he was given a cane and crutches to help him get around.

The man's pain was so unremitting that he stated that he was also having "fatigue and lack of desire to do things." The only care that he was offered during this 10-year period was in the form of opioid therapy. Eventually, he sought care at the Veterans Affairs Medical Center chiropractic clinic.

The chiropractic evaluation of the man’s spine showed a full range of motion, but with pain being created in almost all movements. MRI’s of the man’s lower back showed a disc protrusion in the lower lumbars. Chiropractic care was then started to address his spinal issues. He was also given some home exercises and procedures to follow.

After his sixth visit, the man reported on a re-evaluation that he felt improvement and was able to move better with less pain. After 3 months of chiropractic care, he reported a 50% reduction of pain as well as a "significant increase in his functionality and quality of life." He was able to discontinue the use of opioid medications and only occasionally utilized an over-the-counter drug as needed.

In the discussion, the authors of the study stated, "This case report portrays the ability for a patient with chronic thoracic and low back pain for over a decade, who was previously medically managed for 10 years with daily opioids, to achieve significant improvements with autonomous management of pain, increased functionality, and improved quality of life with a trial of 6 visits of chiropractic care."